title: An audit of outcomes after same-day discharge post-PCI in acute coronary syndrome and elective patients.
abstract: OBJECTIVE
  To investigate the outcomes of a cohort of acute and elective percutaneous coronary intervention (PCI) patients who were discharged home 6 hours postprocedure.
  
  
  BACKGROUND
  Contemporary PCI is safe with a low rate of acute complications. It is well established as a day procedure in elective cases; however, data are lacking in acute cases.
  
  
  METHODS
  We describe a prospective observational audit of routine clinical practice in the 3 PCI centers in Northern Ireland. Patients were selected for same-day discharge after 6 hours of post-PCI observation. Both elective and acute coronary syndrome (ACS) cases were included. Criteria for same-day discharge were based on the technical result of the procedure rather than lesion complexity or clinical presentation. Radial access was preferred but not mandatory. Patients were contacted directly to assess for 30-day major adverse cardiovascular events (MACE). Reported events were corroborated with the general practitioner or hospital notes.
  
  
  RESULTS
  A total of 1,059 patients were selected for same-day discharge with 30-day follow-up available for all cases. Of these, 766 (72.3%) were elective and 293 (27.7%) were ACS patients. Radial access was almost universal (98%). A total of 1,224 lesions were stented, of which 432 (40.8%) were high risk (highest risk lesion in each case by AHA/ACC classification). MACE rate at 30 days was 0.85% with a sub-acute stent thrombosis rate of 0.4%. There were no MACE events from discharge to 24 hours.
  
  
  CONCLUSIONS
  Selected acute and elective patients with a range of lesion complexity and risk can be discharged safely home early after PCI.
authors.affiliation: Cardiology Department, Belfast Health and Social Care Trust, Belfast, UK.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Hodkinson
authors.forename: Adesh
authors.initials: A
authors.lastname: Ramsewak
authors.forename: John Conleth
authors.initials: JC
authors.lastname: Murphy
authors.forename: James A
authors.initials: JA
authors.lastname: Shand
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: McClelland
authors.forename: Ian B A
authors.initials: IB
authors.lastname: Menown
authors.forename: Colm G
authors.initials: CG
authors.lastname: Hanratty
authors.forename: Mark S
authors.initials: MS
authors.lastname: Spence
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Walsh
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D016896:Treatment Outcome